New Surgeon General’s Report Shows Cigarettes Are More Deadly Today than 50 Years Ago

WASHINGTON, DC – Fifty years after the first Surgeon General’s report on smoking and health, the new Surgeon General’s report released today shows that cigarette smoking is even more hazardous than previously thought. This report documents that smoking causes even more diseases, kills even more people and costs the nation even more in medical bills and other economic losses – by a wide margin – than has previously been reported. There are three clear conclusions to be drawn from this groundbreaking report:

While our nation has made remarkable progress in the past 50 years and cut smoking rates by more than half (from 42.4 percent in 1965 to 18.1 percent in 2012), tobacco use continues to have a uniquely devastating impact on the health of individual Americans and the nation as a whole. Each year, smoking kills 480,000Americans – causing about one out of every five deaths in the U.S. It costs the nation at least $289 billion in medical bills and lost productivity, which is nearly $100 billion more than previously reported. Without urgent action to reduce smoking, 5.6 million children under age 18 alive today will die prematurely from smoking-caused disease.

Shockingly, cigarettes are more deadly today than they were 50 years ago because of actions taken by the tobacco industry. The report concludes that smokers' risk of death from all causes, compared to those who never smoked, has gone up significantly over the past 50 years. It also finds that "today" cigarette smokers – both men and women – have a much higher risk of lung cancer and chronic obstructive pulmonary disease (COPD) than smokers in 1964, despite smoking fewer cigarettes" (Executive Summary, p. 1). The report points to changes in the design and composition of cigarettes as the only reasonable explanation for the increased risk of lung cancer.

All of the deaths, diseases and costs caused by tobacco use are entirely preventable by implementing proven strategies developed over the past 50 years. This report leaves no doubt that we know what to do to end the tobacco epidemic – significantly increase tobacco taxes, enact comprehensive smoke-free air laws in every state, conduct hard-hitting mass media campaigns, fully fund state tobacco prevention and cessation programs, provide tobacco users with access to treatments that can help them quit, and effectively implement the Food and Drug Administration's regulatory authority over tobacco products, including graphic warning labels. We know what to do, but have lacked the political will required to get the job done. It is time to fight the tobacco epidemic with a level of urgency and action that matches the enormous scope of the problem. We cannot afford another 50 years of death and disease caused by tobacco.

Cigarettes Have Become More Deadly

The report shows that cigarettes are more deadly today than they were 50 years ago. Its findings include:

During the past 50 years, smokers’ risk of death from all causes, compared to non-smokers, has more than doubled in men and more than tripled in women. The report concludes: "The evidence is sufficient to infer that the relative risk of dying from cigarette smoking has increased over the last 50 years in men and women in the United States." (Executive Summary, p. 7 and 11)

Since 1959, the lung cancer risk for people who never smoked has stayed about the same, but the risk for smokers increased steadily. The lung cancer risk increased tenfold for female smokers and doubled for male smokers. (Executive Summary p. 6)

The report links the increase in lung cancer risk among smokers to changes in the design and composition of cigarettes: "The evidence is sufficient to conclude that the increased risk of adenocarcinoma of the lung in smokers resulted from changes in the design and composition of cigarettes since the 1950s." The increased risk of adenocarcinoma is the reason for the overall increase in lung cancer. The report adds, "The evidence is not sufficient to specify what design changes are responsible for the increased risk of adenocarcinoma, but there is suggestive evidence that ventilated filters and increased levels of tobacco-specific nitrosamines [a carcinogen] have played a role." (Executive Summary, pages 6 and 8)

It is deeply disturbing that 50 years after the tobacco industry and the public learned conclusively that smoking causes lung cancer, cigarettes are even more dangerous and pose an even greater risk of lung cancer. Even worse, no government agency had the power to find out about it, prevent the changes that caused it or do anything about it until Congress granted the FDA authority over tobacco products in 2009. In light of the new report, the FDA must make it a priority to regulate how tobacco products are made and take action to stop tobacco industry practices that make their products even more harmful or addictive.

Tobacco Kills and Costs Even More

The new report drives home the magnitude of the harm resulting from tobacco use, which is the nation's number one cause of preventable death. Key findings include:

Over the past 50 years, more than 20 million Americans have died as a result of smoking, including 2.5 million nonsmokers who died from heart disease or lung cancer caused by exposure to secondhand smoke.

The report adds several more diseases to the long list caused by smoking, including colorectal and liver cancer, diabetes and rheumatoid arthritis. In 1964, the Surgeon General concluded definitively that smoking causes lung cancer. Today, we know that smoking causes at least 13 types of cancer.

Smoking causes 480,000 premature deaths annually among Americans, an increase from the previous estimate of 443,000.

The economic costs of smoking are far greater than previously thought. These costs total $289-$332.5 billion a year, including $132.5-$175.9 billion for direct medical care of adults, $151 billion for lost productivity due to premature death and $5.6 billion for lost productivity due to exposure to secondhand smoke. Previous estimates put the annual economic costs at $193 billion, including $96 billion in health care costs and $97 billion in lost productivity.

A Road Map for Ending the Tobacco Epidemic

Last week, the Campaign for Tobacco-Free Kids and six other public health and medical organizations called for bold action to achieve three goals: 1) Reduce smoking rates to less than 10 percent within 10 years; 2) protect all Americans from secondhand smoke within five years; and 3) ultimately eliminate the death and disease caused by tobacco use.

The new report confirms that we have scientifically proven strategies to achieve these goals and lays out a detailed road map for implementing these strategies more aggressively than ever before. Specific actions called for by the report include:

Continuation and expansion of national media campaigns such as the CDC's Tips from Former Smokers campaign and the FDA's upcoming youth prevention campaign. The report calls for conducting such campaigns "at a high frequency level and exposure for 12 months a year for a decade or more."

Increasing cigarette taxes to prevent kids from smoking and encourage smokers to quit.

Effective implementation of the FDA's authority over tobacco products "in order to reduce tobacco product addictiveness and harmfulness."

Fully funding state tobacco prevention and cessation programs at CDC-recommended levels. Currently, only two states (North Dakota and Alaska) meet that standard, and most states fall woefully short.

Enacting comprehensive smoke-free laws that protect all Americans from secondhand smoke. Currently 24 states, Washington, DC and hundreds of cities have such laws, protecting 49.1 percent of the U .S. population.

It is now the responsibility of elected officials at all levels of government to fully implement these recommendations. The status quo is unacceptable. We cannot and will not claim victory until every child is tobacco-free and we have eliminated the death and disease caused by tobacco. It must not take another 50 years.